Provider Demographics
NPI:1134722903
Name:PEARSON, KYLE AARON (DPT)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:AARON
Last Name:PEARSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FAIRVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3114
Mailing Address - Country:US
Mailing Address - Phone:978-353-9191
Mailing Address - Fax:
Practice Address - Street 1:1010 GRAND ARMY HWY
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4566
Practice Address - Country:US
Practice Address - Phone:508-675-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist